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Idaho rates for HCPCS 99427

Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death, the condition requires development, monitoring, or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care; each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

Facilitymedian $43 · 10th–90th $30–$680%10%10th90th$43Professionalmedian $40 · 10th–90th $28–$710%10%10th90th$40$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $38.90 / $57.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $70.79 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $61.66 / $87.10
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $42.66 / $66.07
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $54.95 / $97.72
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $60.26 / $77.62
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $51.29 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $53.70 / $77.62